CQC report explained · a residential care home
What the CQC found at Ann Marie Howes Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, suitable recruitment checks, safe medicines management and staff who understood safeguarding. Infection prevention measures were also found to be in place.
- Effective?
- Requires improvement
- The report does not give a separate Effective rating or detailed Effective findings.
- Caring?
- Good
- People were supported by kind and caring staff. Inspectors saw people being treated with dignity and respect, given choices and involved in their care.
- Responsive?
- Good
- Care plans contained personalised information and were reviewed regularly. People were offered activities based on their preferences and were supported to stay in touch with relatives.
- Well-led?
- Good
- The new manager had introduced audits, staff meetings and more regular staff huddles. Inspectors found that previous governance improvements had been made, although some short-stay care documents were not initially up to date.
What inspectors found, April 2021
Ann Marie Howes Centre was rated Good; inspectors found kind, safe care and improvements since the previous inspection.
Inspectors visited without warning on 25 March 2021. They spoke with people living there, relatives, staff and a health professional. They also reviewed care records, medicines records, recruitment checks and management documents.
The home was rated Good overall. Safe, Caring, Responsive and Well-led were all rated Good. Inspectors found that medicines were given safely, staff understood safeguarding, people were treated with kindness and care plans reflected people's needs and preferences.
The rating improved from Requires Improvement at the previous inspection, published in July 2020. The provider had previously breached two regulations, but inspectors found enough improvement had been made and there were no current breaches.
The inspection was prompted partly by allegations of sexual abuse and poor care. The report says the circumstances of the sexual abuse allegation were subject to a criminal investigation and were not examined during this inspection.
Safe care and medicines
Staff understood people's risks and safeguarding responsibilities. Medicines records showed people received their medicines as prescribed.
“Medicines administration records we observed showed people received their medicines as prescribed.” from the report
Kind and respectful staff
People and relatives described caring staff. Inspectors observed respectful interactions and staff knocking before entering bedrooms.
“On the day of inspection we observed that people were treated with dignity and respect and we saw some really nice interactions between people and staff.” from the report
Personalised support
Care plans recorded people's individual needs and communication preferences. Activities and choices were arranged around what people wanted.
“Care plans contained personalised information to enable staff to provide person centred care.” from the report
Family contact and activities
The home supported people to take part in activities and maintain contact with relatives during the pandemic.
“The provider had purchased telephones for people to use during the pandemic to keep in touch with their relatives by the use of Skype and Face Time.” from the report
Improved management
The new manager had introduced audits, staff huddles and staff support arrangements. Staff said management was approachable and supportive.
“The manager carried out audits to monitor and improve the quality of the service.” from the report
Short-stay records were not initially complete
needs fixingNot all short-stay residents had updated care plans and risk assessments when inspectors arrived. The manager had identified this and completed the documents during the inspection.
“Not all short stay residents had updated care plans/risk assessments in place when we visited” from the report
- 01How do you make sure care plans and risk assessments are updated promptly for short-stay residents?
- 02What changes have been made since the previous inspection, and how do your audits show that they are working?
- 03How are safeguarding concerns and allegations handled, and how would you keep families informed?
- 04How will you support my relative's preferred activities, communication needs and contact with family?
- 05How do you check that medicines continue to be given safely and that staff remain competent?
This was a focused inspection of Safe and Well-led, with Caring and Responsive also inspected after positive feedback; the Effective rating was not given in this report and some ratings from earlier inspections were used in calculating the overall rating. This explanation was written from the published report of 28 April 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, July 2020
Ann Marie Howes Centre was rated Requires Improvement; inspectors found significant risks in care, nutrition, activities and management, and the rating fell from Good.
Inspectors made an unannounced visit on 9 and 10 January 2020. They spoke with people, staff and a health professional, observed care, checked the building and reviewed care, medicine, staffing and management records.
The home was not always safe or effective. Risk assessments and care plans were not reliably updated. Inspectors found serious concerns about falls, allergies, prescribed diets, fluid monitoring, infection control and missed health appointments. Some medicines were given as prescribed, but records for some creams were incomplete.
Staff were described as kind and caring, but people were not always treated with dignity or supported to be independent. There were too few meaningful activities, and people could become socially isolated. The home had not carried out internal audits for over a year, so problems were not identified and dealt with promptly.
All five areas were rated Requires Improvement. This means the service was not consistently meeting the expected standards and there was an increased risk of people being harmed. The provider was required to make improvements and the CQC planned to monitor progress and reinspect.
Kind and respectful staff
People described staff as kind and caring, and inspectors saw positive interactions. Staff generally respected privacy and confidentiality.
“People described staff as kind and caring and said their privacy was respected.” from the report
Medicines usually given correctly
Inspectors found that people received their medicines as prescribed. Staff had received medicines training.
“Inspectors found that people received their medications as prescribed.” from the report
Staff training
Staff had induction and refresher training. Records showed that staff either held a health and social care qualification or had completed the care certificate.
“Staff received induction and refresher training and either had a health and social care qualification or had completed the care certificate.” from the report
Partnership working
The home worked with families, GPs, mental health services and district nurses. A district nurse clinic was available at the home.
“There was an arrangement in place between the district nurses and the care home to provide people with a district nurse clinic at the care home.” from the report
Poor management of known risks
seriousRisk assessments were not updated and falls were not properly analysed or investigated. One person had 21 falls over seven months, leaving people at ongoing risk of harm.
“One person had sustained 21 falls between June 2019 and January 2020.” from the report
Allergy and diet risks
seriousA person's food allergy was not recorded clearly and staff continued to provide foods that caused an allergic reaction risk. Another person's prescribed diet was not provided for six months.
“Staff were not aware of the allergy and continued to give the person the foods to which they were allergic.” from the report
Nutrition and health follow-up
seriousFluid targets were not entered into the monitoring system. Some people missed planned tests or appointments, which contributed to ongoing symptoms and risks to their health.
“People did not always receive a coordinated approach between the care home and external health services.” from the report
Infection control and unsafe storage
needs fixingContinence pads, stoma bags and protective equipment were left loose and could be contaminated. Cleaning fluid was stored in a cupboard with drinks and was accessible to people and visitors.
“This meant that people were at risk from cross infection.” from the report
Limited activities and social contact
needs fixingThere was no dedicated activities worker and staffing levels limited day-to-day activities and trips out. Inspectors saw people sitting without meaningful activity.
“People were not effectively supported to avoid social isolation.” from the report
Weak oversight and records
seriousThe home had not completed an internal audit for over a year. Its systems failed to identify several care, medicine, infection control and health follow-up problems.
“The last internal audit of the service was in 2018.” from the report
- 01What action has been taken to investigate and reduce repeated falls, and how are new falls reviewed?
- 02How are food allergies, prescribed diets and fluid targets recorded and checked for every person?
- 03What changes have been made to ensure health appointments, blood tests and other agreed actions are not missed?
- 04How many meaningful activities are now available each week, and how are people supported to go out into the community?
- 05When was the most recent internal quality audit, and what evidence shows that the risks identified in this report have been resolved?
This was an unannounced inspection covering all five CQC questions and both the premises and care provided; all five ratings changed from Good at the previous inspection to Requires Improvement. This explanation was written from the published report of 30 July 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Ann Marie Howes Centre
4 rated inspections over 6 years: the service has held its Good rating throughout.
- April 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- July 2020Requires improvementdown from GoodSafe: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 23 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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